A common, and often perplexing, diagnostic challenge is the unfortunate person with recurrent abdominal pain. When a searching history, thorough physical examination, laboratory evaluation, and radiological studies are to no avail, such patients are often labeled neurotic, or advised to undergo exploratory surgery. It is in such a setting that the subject of abdominal epilepsy is occasionally raised. Since in our experience physicians know little about this rare entity, we feel a brief review is pertinent at this time.
Experimental studies in both animal and human subjects have shown that stimulation of certain areas in the brain stem, hypothalamus, and cerebral cortex can influence gastrointestinal activity and cause a variety of visceral sensations.1-5 Up to 20% of patients with convulsive disorders, particularly those with temporal lobe seizures, will experience a visceral aura such as epigastric distress, peculiar "rising sensations," nausea, vomiting, salivation, and borborygmi.4,6 Usually these symptoms are